Short answer: An employee who turns down the employer’s health plan should sign a waiver documenting the choice. Waiving usually means waiting until the next open enrollment to join, unless a later qualifying life event triggers a special enrollment period.
Employees aren’t required to take the employer’s coverage, but those who decline should complete a waiver (declination) form. Documenting the waiver matters for several reasons: it proves the employer made a valid offer (important for ACA reporting and the employer mandate), it supports the carrier’s participation requirements, and it records the employee’s reason, often that they have other coverage through a spouse, parent, Medicare, or Medicaid.
Once an employee waives, they generally cannot join the plan until the next open enrollment. The key exception is a qualifying life event (marriage, birth, loss of other coverage, etc.), which opens a special enrollment period that lets them enroll mid-year. Encouraging employees to capture the reason for a waiver also helps employers meet carrier participation thresholds, since waivers backed by other coverage are usually excluded from the participation calculation.
Sources
- HIPAA special enrollment rights, 29 CFR §2590.701-6; plan administration and carrier participation rules.
Content history
Originally published: June 16, 2026
Last reviewed: June 16, 2026